Assessing the efficacy of various irrigation solutions in dissolving organic tissue

For successful root canal treatment, adequate chemomechanical instrumentation to eliminate microorganisms and pulp tissue is crucial. This study aims to assess the organic tissue dissolving activity of various irrigation solutions on bovine tooth pulp tissue. 40 extracted bovine mandibular anterior teeth (n = 10) were used for the study. Bovine pulp pieces (25 ± 5 mg) were placed in 1.5 ml Eppendorf tubes. Each tooth pulp sample was then covered with 1.5 ml of different irrigation solutions, dividing them into four groups: Group 1 with freshly prepared 5% Boric acid, Group 2 with 5% NaOCl, Group 3 with Irritrol, and Group 4 with Saline. Samples were left at room temperature for 30 min, then dried and reweighed. The efficacy of tissue dissolution ranked from highest to lowest was found to be NaOCl, Boric Acid, Irritrol, and saline (p < 0.05). It was observed that the decrease in the NaOCl group was greater than the decrease in the Irritrol and saline groups, and the decrease in the Boric acid group was significantly greater than the decrease in the saline group (p < 0.05). It also emphasizes the need for future studies to further investigate the effects of Irritrol and Boric Acid on tissue dissolution.

alone can leave 40-50% of canal walls untouched, potentially creating an environment for residual living tissue fragments where microorganisms can thrive and lead to persistent infections [18][19][20] .It is stated that NaOCl is the gold standard irrigation agent used in endodontics, and the use of Boric acid or Irritrol cannot replace the use of NaOCl in endodontics.Additionally, Irritrol has been shown to have poor smear layer removal and antibacterial properties 21 .However, literature review reveals limited studies on the tissue-dissolving capabilities of irrigation solutions other than NaOCl, such as Boric Acid and Irritrol.This study aims to evaluate the organic tissue dissolving activity of various irrigation solutions on bovine tooth pulp tissue.The null hypothesis posits that, aside from saline, the other tissue dissolvers used in this study effectively dissolve bovine pulp.

Data acquisition
Our research utilized 40 extracted bovine mandibular anterior teeth (n = 10), obtained from Panagro Meat and Dairy Integrated Facilities (Meram, Konya, TURKEY).Teeth harvested one day before the experiment were stored at − 20 degrees Celsius in a freezer.Before starting the study, the teeth were thawed to room temperature.Using a diamond bur, the teeth were horizontally cut at the enamel-cement junction to separate the crown and root portions.Pulp tissue was extracted from the root canal with fine-tipped forceps, with excess blood and debris washed away with distilled water.The samples were kept in the tubes at room temperature for half an hour, then dried with paper towels and weighed on a precision scale.Then, the pulp was divided into pieces weighing approximately 25 ± 5 mg with the help of a #12 scalpel.These weighed bovine pulp segments were placed into 1.5 ml Eppendorf tubes.Each tooth pulp sample was then covered with 1.5 ml of different irrigation solutions, dividing them into four groups: Group 1 with freshly prepared 5% Boric acid, Group 2 with 5% NaOCl (pH ~ 12) (Microvem, Istanbul, Turkey), Group 3 with Irritrol (Essential Dental Systems, New Jersey, USA), and Group 4 with Saline (Polifleks, Polifarma, İstanbul, Turkey).The samples were dried again and weighed again on a precision balance.The difference between the initial and final measurements was statistically analyzed.

Statistical analysis
In the G*Power 3.1.9.7 power analysis performed with the parameters of 80% power, 0.05 alpha error rate, and 0.58 effect size, it was calculated that we needed 40 samples in total.
In this study, data were analyzed using the licensed IBM SPSS 21 (SPSS Inc., Chicago, IL, ABD) software package.To determine whether variables followed a normal distribution, the Shapiro-Wilk and/or Kolmogorov-Smirnov tests were utilized due to the sample sizes.A significance level of 0.05 was adopted for interpretations; variables were considered not to follow a normal distribution if p < 0.05, and to follow a normal distribution if p > 0.05.In examining differences between groups, the Kruskal-Wallis H test was employed for variables not following a normal distribution.Significant differences identified by the Kruskal-Wallis H test led to further analysis with the Post-Hoc Multiple Comparison Test to pinpoint the groups between which differences existed.For examining differences between two related variables that did not follow a normal distribution, the Wilcoxon Test was used.A significance level of 0.05 was applied for interpretations, where p < 0.05 indicated a significant difference, and p > 0.05 indicated no significant difference.
The initial measurement values of the samples before any procedure show no statistically significant difference between groups as seen in Table 1 (p > 0.05).
As presented in Table 2, there is a statistically significant difference between the groups in terms of the final measurement values after the samples were exposed to the solutions (p < 0.05).The final measurement value of the NaOCl group is significantly lower compared to the Irritrol and saline groups; similarly, the final measurement value of the Boric Acid group is significantly lower compared to the saline group.
Statistically significant differences between groups in terms of change values are observed in Table 3 (p < 0.05).The decrease in the NaOCl group is significantly greater compared to the decreases in the Irritrol and saline groups; similarly, the decrease in the Boric acid group is significantly greater than the decrease in the saline group.It was observed that the tissue dissolving properties of the NaOCl group were statistically significantly higher than the other groups.

Table 1 .
This study was conducted in accordance with Arrive guidelines and ethical approval was received from Karamanoğlu Mehmetbey University Faculty of Medicine Local Scientific Medical Research Ethics Committee (01-2024/21).Differences between groups in terms of ınitial measurement values.

Table 2 .
Differences between groups in terms of final measurement values.

Table 3 .
Differences between groups in terms of change values.